Organization
GRS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CELINE BAKER COTA (COTA)
(802) 747-6456
Entity
Organization
Contact information
Practice address
9 HAYWOOD AVE, RUTLAND, VT 05701-4832
(802) 747-6456
Mailing address
9 HAYWOOD AVE, RUTLAND, VT 05701-4832
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
073.0123765
VT
Other
Enumeration date
02/02/2017
Last updated
02/02/2017
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